Circadian Influences on Brain Lipid Metabolism and Neurodegenerative Diseases.

Circadian rhythms are intrinsic, 24 h cycles that regulate key physiological, mental, and behavioral processes, including sleep-wake cycles, hormone secretion, and metabolism. These rhythms are controlled by the brain's suprachiasmatic nucleus, which synchronizes with environmental signals, such as light and temperature, and consequently maintains alignment with the day-night cycle. Molecular feedback loops, driven by core circadian "clock genes", such as Clock, Bmal1, Per, and Cry, are essential for rhythmic gene expression; disruptions in these feedback loops are associated with various health issues.

Increased copeptin may reflect vasopressin-related metabolic changes after bariatric surgery.

Objective: Mechanisms underlying metabolic improvement following metabolic and bariatric surgery (MBS) may provide insight into novel therapies. Vasopressin improves body composition and protects against hypoglycemia. Associations of copeptin, a stable cleavage product of vasopressin, with BMI and insulin resistance suggest an adaptive increase in vasopressin to counteract metabolic disruption.

Sex and Gender Considerations in Orthopaedic Research: Existing Barriers, What's Needed by Institutions and Research Departments, and How to Guide Junior Investigators and Faculty.

JBJS convened a symposium to discuss the reporting of sex and gender in research studies as an imperative to improve research methods and results to benefit all patients. Barriers to improved reporting include a lack of societal and cultural acceptance of its need; a lack of education regarding appropriate terminology and appropriate statistical methods and efficient study designs; a need for increased research funding to support larger group sizes; unknown concordance of cell and animal models with humans to reflect biologic variables such as sex; and a lack of understanding of key considerations of gender, race, and other social determinants of health and how these factors intersect. Attention to developing and disseminating best-practice statistical methods and to educating investigators (at all career levels), reviewers, funders, editors, and staff in their proper implementation will aid reporting.

Molecular Testing for the World Health Organization Classification of Central Nervous System Tumors: A Review.

Importance: Molecular techniques, including next-generation sequencing, genomic copy number profiling, fusion transcript detection, and genomic DNA methylation arrays, are now indispensable tools for the workup of central nervous system (CNS) tumors. Yet there remains a great deal of heterogeneity in using such biomarker testing across institutions and hospital systems. This is in large part because there is a persistent reluctance among third-party payers to cover molecular testing.

HBV-Induced Carcinogenesis: Mechanisms, Correlation With Viral Suppression, and Implications for Treatment.

Background: Chronic hepatitis B virus (HBV) infection is a common but underdiagnosed and undertreated health condition and is the leading cause of hepatocellular carcinoma (HCC) worldwide. HBV (rated a Grade 1 carcinogen by the International Agency for Research on Cancer) drives the transformation of hepatocytes in multiple ways by inducing viral DNA integrations, genetic dysregulation, chromosomal translocations, chronic inflammation, and oncogenic pathways facilitated by some HBV proteins. Importantly, these mechanisms are active throughout all phases of HBV infection.

Effect of Time to Surgery on Surgical Site Infection in Open Distal Radius Fractures: A Review of the ACS Trauma Quality Improvement Program Database.

Introduction: Managing open distal radius fractures (DRFs) poses challenges. While preventing surgical site infection (SSI) involves prompt antibiotic administration and thorough irrigation and debridement, the impact of urgent intervention on reducing postoperative infection rates is debated. We hypothesize that timing of surgery does not significantly affect the incidence of SSI in open DRF treated within or after 24 hours from time of injury.

Mixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions.

This state-of-the-art review describes the potential etiologies, pathophysiology, and management of mixed shock in the context of a proposed novel classification system. Cardiogenic-vasodilatory shock occurs when cardiogenic shock is complicated by inappropriate vasodilation, impairing compensatory mechanisms, and contributing to worsening shock. Vasodilatory-cardiogenic shock occurs when vasodilatory shock is complicated by myocardial dysfunction, resulting in low cardiac output.

The Leaky Preexposure Prophylaxis Cascade: Barriers and Facilitators to Preexposure Prophylaxis Uptake and Adherence Among Youth Experiencing Homelessness in the US South, a Mixed Methods Study.

Adherence to preexposure prophylaxis (PrEP) is lower among high-risk populations, including youth experiencing homelessness (YEH). This study determined the feasibility of urine PrEP adherence biomarker testing and examined the barriers and facilitators to PrEP uptake and adherence among YEH. YEH were recruited from a randomized control trial conducted in a large urban setting in southern United States.

Disparities in mortality outcomes among older adults with communication disabilities using the National Health and Aging Trends Study.

Objective: To examine if a nationally representative population of older adults with communication disabilities (CDs) have a higher risk of mortality when compared to older adults without these disabilities, independent of sociodemographic, health, and other disability characteristics.

Design: Retrospective, cohort study. We conducted a survival analysis using multivariable Cox-proportional hazards regression, adjusting for sociodemographic, health, and other disability characteristics.

Restrictive versus Liberal Transfusion in Myocardial Infarction - A Patient-Level Meta-Analysis.

Background: Clinical guidelines have concluded that there are insufficient data to provide recommendations for the hemoglobin threshold for the use of red cell transfusion in patients with acute myocardial infarction (MI) and anemia. After the recent publication of the Myocardial Infarction and Transfusion (MINT) trial, we performed an individual patient-level data meta-analysis to evaluate the effect of restrictive versus liberal blood transfusion strategies.

Methods: We conducted searches in major databases.

Inflammation in the Peri-ACS Period: Ready for Prime Time?

Inflammation has been demonstrated to negatively impact patients in the peri-ACS period. This narrative review outlines the inflammatory response in ACS, highlighting the role of the NLRP3 inflammasome pathway following acute plaque rupture and coronary intervention and its potential as a pharmacologic target. RECENT: nvestigators have leveraged medications targeting the NLRP3 inflammasome currently used for other inflammatory pathologies, including colchicine, tocilizumab and anakinra.

VGLL-fusions define a new class of intraparenchymal CNS schwannoma.

Background: Intracerebral schwannomas are rare tumors resembling their peripheral nerve sheath counterparts but localized in the CNS. They are not classified as a separate tumor type in the 2021 WHO classification. This study aimed to compile and characterize these rare neoplasms morphologically and molecularly.

Correlation-weighted Na magnetic resonance fingerprinting in the brain.

We developed a new sodium magnetic resonance fingerprinting (Na MRF) method for the simultaneous mapping of and sodium density with built-in (radiofrequency transmission inhomogeneities) and corrections (frequency offsets). We based our Na MRF implementation on a 3D FLORET sequence with 23 radiofrequency pulses. To capture the complex spin dynamics of the Na nucleus, the fingerprint dictionary was simulated using the irreducible spherical tensor operators formalism.

Phosphopeptide Neoantigens as Emerging Targets in Cancer Immunotherapy.

Protein post-translational modifications play a vital role in various cellular events essential for maintaining cellular physiology and homeostasis. In cancer cells, aberrant post-translational modifications such as glycosylation, acetylation, and phosphorylation on proteins can result in the generation of antigenic peptide variants presented in complex with MHC molecules. These modified peptides add to the class of tumorspecific antigens and offer promising avenues for targeted anti- cancer therapies.

Healthcare Utilization Patterns in Sickle Cell Patients and Their Association With Sickle Cell Retinopathy.

Background/aim: A few shave identified systemic and hematologic risk factors for Proliferative Sickle Cell Retinopathy (PSR) development. The relevance of healthcare utilization as a risk factor for PSR has not been defined. This study evaluates patterns of healthcare utilization among patients with sickle cell disease (SCD) and retinopathy.

How i do it: Leveraging AutoHotkey and programmable peripheral devices for high efficiency diagnostic radiology.

This paper discusses the use of AutoHotkey (AHK) and programmable peripheral computing devices to enhance the workflow of diagnostic radiologists. Multiple features designed and coded by an emergency teleradiologist to optimize efficiency and complete redundant tasks with ease are presented. The full AutoHotkey script, which currently supports Visage PACS, PowerScribe 360, and Epic EHR, is available in the article appendix.

Impact of Financial Toxicity on Treatment Adherence and Quality of Life in Pancreatic Cancer.

Purpose: Financial toxicity (FT) is increasingly recognized as a major issue in cancer care. We evaluated the prevalence and risk factors for FT in patients with pancreatic ductal adenocarcinoma (PDAC) and FT associations with treatment adherence and quality of life (QOL).

Methods: A screening questionnaire based on the Comprehensive Score for Financial Toxicity (COST) was implemented at our National Cancer Institute-designated comprehensive cancer center.

A phase 1 study of the CDK9 inhibitor voruciclib in relapsed/refractory acute myeloid leukemia and B-cell malignancies.

The anti-apoptotic protein myeloid cell leukemia-1 (Mcl-1) contributes to the pathophysiology of acute myeloid leukemia (AML) and certain B-cell malignancies. Tumor dependence on Mcl-1 is associated with resistance to venetoclax. Voruciclib, an oral cyclin-dependent kinase (CDK) inhibitor targeting CDK9, indirectly decreases Mcl-1 protein expression and synergizes with venetoclax in preclinical models.

One-Pot Assay Based on CRISPR/Cas13a Technology for HEV RNA Point-of-Care Testing.

Hepatitis E virus (HEV) poses a serious threat to both public health and animal food safety, thereby highlighting the demands for rapid, sensitive, and easy-to-use detection. This study aimed to develop a One-Pot assay using CRISPR/Cas13a for detecting HEV RNA, suitable for point-of-care testing (POCT) in resource-limited settings. CRISPR/Cas13a combined with reverse transcription polymerase chain reaction (RT-PCR) and reverse transcription recombinase-aided amplification (RT-RAA) was applied to a One-Pot assay device.